Pathophysiology of Gastroesophageal Reflux Disease

Jan Tack*, John E. Pandolfino

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

71 Scopus citations

Abstract

The pathogenesis of gastroesophageal reflux disease (GERD) is complex and involves changes in reflux exposure, epithelial resistance, and visceral sensitivity. The gastric refluxate is a noxious material that injures the esophagus and elicits symptoms. Esophageal exposure to gastric refluxate is the primary determinant of disease severity. This exposure arises via compromise of the anti-reflux barrier and reduced ability of the esophagus to clear and buffer the refluxate, leading to reflux disease. However, complications and symptoms also occur in the context of normal reflux burden, when there is either poor epithelial resistance or increased visceral sensitivity. Reflux therefore develops via alterations in the balance of aggressive and defensive forces.

Original languageEnglish (US)
Pages (from-to)277-288
Number of pages12
JournalGastroenterology
Volume154
Issue number2
DOIs
StatePublished - Jan 2018

Keywords

  • Acid Exposure
  • Esophageal Motility
  • Esophageal Sensitivity
  • Hiatal Hernia
  • Transient Lower Esophageal Sphincter Relaxations

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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